Provider Demographics
NPI:1487797791
Name:PAMELA MERINO MD PA
Entity type:Organization
Organization Name:PAMELA MERINO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:305-774-7653
Mailing Address - Street 1:6705 S RED RD
Mailing Address - Street 2:SUITE 510
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3622
Mailing Address - Country:US
Mailing Address - Phone:305-774-7653
Mailing Address - Fax:305-675-6453
Practice Address - Street 1:6705 S RED RD
Practice Address - Street 2:SUITE 510
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3622
Practice Address - Country:US
Practice Address - Phone:305-774-7653
Practice Address - Fax:305-675-6453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91134207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty